Avik Roy, a conservative health care expert who’s finding it harder and harder to be “conservative”, struggles with Lyin’ Paulie Ryan’s latest wrinkle to the Health Care bill that he and Donald Trump are trying to “ram” through the House of Representatives. The original bill had sort of a problem, noted by ethical gal around town Mona Charen, to wit: “the subsidies AHCA offers to those making between $75,000 and $150,000 are actually more generous than Obamacare’s subsidies. For the working poor, by contrast, who make too much to qualify for Medicaid, the subsidies would be much smaller and probably inadequate.”
Well, to boost those subsidies for the working poor—old working poor in particular—Ryan has offered an amendment, supposedly providing $85 billion in new money for those folks. The only problem, is, as Roy points out, the money isn’t there. What Ryan is offering is tax deductibility, not targeted by age, which, when you have no taxable income, amounts to a big fat zero—though it would benefit rich folks, who do have taxable income. So that’s something. For the rich folks, at least.
But wait, there’s more! A lot more!
Well, for the really rich folks, at least, because an Obamacare tax that hits only the top earners, originally scheduled for repeal in 2018, will now be repealed effective 2017. As Roy notes, “it’s curious that extending tax cuts was a higher priority for the House than addressing the fact that the bill will make insurance unaffordable for millions of Americans.” Since the “hard right” Republicans wanted to eliminate all subsidies for low-income Americans, Avik, I don’t think it’s “curious” at all.
Afterwords
Roy titles his piece “One Step Forward, One Step Backward”, but, even by his standards, I count two steps forward but five steps backward. Roy updates his post with a quote from a Wash Post piece from a moderate Republican House member saying he’s satisfied that the bill will help “the poor and those who are up in years.” So I guess we’ll see who’s right. But, anyway, if you’re rich, you don’t have to worry! Lyin’ Paulie Ryan is on your side!
Afterwords II
According to Jennifer Haberkorn, Rachel Bade, and Josh Dawsey at Politico, Ryan’s amendment doesn’t make the change, but “would instruct the Senate to do so, forcing House Republicans to take a vote on something the upper chamber would do later. It would be paid for by allowing consumers to write off less medical debt.” So at this point it seems that 1) there isn’t any definite proposal at all, 2) the Senate might do anything it pleases, and 3) whatever the Senate does come up with, the House might reject it. So if you’re between the ages of 50 and 64, not making a lot of cash, don’t start poppin’ any champagne corks any time soon.
Afterwords III
One can guess that Ryan’s strategy is to pass a “hard” bill, with no Democratic votes, and once it’s approved by both houses, invite the Democrats to help him soften it. “You don’t want all those poor folks to go without health insurance, do you?” This would involve, basically, double-crossing just about everyone, but they don’t call him Lyin’ Paulie Ryan for nothing.